张家界市首例C群流脑死亡病例及其密接人群中分离的脑膜炎奈瑟菌实验室分析和PFGE分型  

Laboratory Analysis and PFGE Typing of the Neisseria Meningitidis Strains Isolated from the First Serogruop C Neisseria Meningitidis Death Case and her Close Contacts in Zhangjiajie City

作　　者：田晓辉[1] 夏昕[2] 王敏[1] 戴德芳[2] 

机构地区：[1]湖南省张家界市疾病预防控制中心,湖南张家界427000 [2]湖南省疾病预防控制中心

出　　处：《实用预防医学》2012年第9期1311-1313,1295,共4页Practical Preventive Medicine

摘　　要：目的了解张家界市首例C群流脑死亡病例及其密切接触人群中分离到的11株脑膜炎奈瑟菌的病原学特征及其流行关系。方法经培养及生化鉴定后,对菌株进行血清学及聚合酶链反应(PCR)鉴定分群,最后采用最低抑菌浓度(MIC)琼脂稀释法进行药敏试验;脉冲场凝胶电泳对菌株进行PFGE分型分析。结果通过生化、血清学和PCR实验共鉴定到9株C群脑膜炎奈瑟菌和2株W135群脑膜炎奈瑟菌,药敏试验中所有菌株对青霉素、氨苄西林、米诺环素、头孢曲松、头孢噻肟、氯霉素、阿奇霉素、美罗培南和利福平全部敏感;对复方磺胺甲口恶唑全部耐药;对环丙沙星和左氧氟沙星部分耐药,PFGE结果显示11株菌株共分为两个带型,其中9株C群脑膜炎奈瑟菌菌株带型完全相同。结论 C群和W135群可能成为新的流脑流行群引起疾病,分离的菌株对大部分抗生素仍较敏感,但要注意耐药趋势,造成该病例死亡的病原菌为C群脑膜炎奈瑟菌,与其密接同学中分离到的C群脑膜炎奈瑟菌的PFGE分型呈现高度一致性,提示为同一克隆群。Objective To explore the pathogenic characteristics and the epidemic associations of the 11 Neisseria meningi- tidis strains isolated from the first serogroup C Neisseria meningitidis death case and her close contacts in Zhangjiajie City. Methods After culture and biochemical identification, the Neisseria meningitidis strains isolated were identified and clustered by serological and PCR tests. Drug sensitivity was tested for minimum inhibitory concentration （MIC） by agar dilution method. Molecular typing was performed by pulsed field gel electrophoresis （PFGE）. Results Nine serogroup C strains and two sero- group W135 strains were identified by biochemical, serological and PCR tests. All of the 11 strains were sensitive to penicillin, ampicillin, minocycline, ceftriaxone, cefotaxime, chloramphenicol, azithromyein, meropenem and rifampicin. All were resistant to sulfamethoxazole, and some were resistant to ciprotloxacin and levofloxacin. PFGE indicated that 11 strains showed two band- ing patterns, and 9 serogroup C Neisseria meningitidis strains displayed the same banding pattern. Conclusions Serogroup C and W135 Neisseria rneningitidis may become the new primary epidemic strains of epidemic cerebrospinal meningitis. The isolates are sensitive to most of the antibiotics, but antibiotic resistance trend should be noticed. PFGE typing of the serogroup C strains isolated from the death case and her close contact classmates indicates high consistency, which suggests that the isolates are the same clone serogroup.

关 键 词：流行性脑脊髓膜炎 脑膜炎奈瑟球菌C群 聚合酶链反应 脉冲场凝胶电泳 

分 类 号：R515.2[医药卫生—内科学]